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To determine the most effective methods for reducing pain from propofol injection, researchers performed a meta-analysis of 177 randomized controlled trials in which 19 different drugs and 8 nondrug interventions or combinations were evaluated in 25,250 adult patients receiving intravenous propofol.
Overall, about 60% of patients in the control groups reported pain with injection of propofol alone. Injection into an antecubital vein instead of a hand vein was the most effective technique for reducing pain (relative risk, 0.14). Lidocaine pretreatment combined with venous occlusion was also effective (RR, 0.29). Other effective interventions included lidocaine–propofol admixture (RR, 0.40) and pretreatment with opioids (RR, 0.49), lidocaine (…